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Pain is often worsened by sitting, standing for long periods, coughing, or sneezing

On the cognitive side, brain fog, slower reaction time, difficulty concentrating, and headaches are common

They develop gradually over time and may include: Hair loss Premature hair graying Mouth ulcers Breathlessness Pale yellow skin Disturbed vision Numbness, tingling, or pricking in the hands, feet, or legs Difficulty walking and moving around Irritability Depression Poor memory and low cognition Muscle weakness Fatigue (2) Miriam Diaz-Gilbert, a blogger, had a debilitating encounter with vitamin B12 deficiency